In fiscal year 2009, we published the data on hand-foot skin reaction related to sorafenib therapy from three NCI intramural trials to better understand the potential risk factors and possible pathogenesis of this painful treatment-limiting cutaneous adverse effect. This research required multi-specialty collaboration among dermatologists, oncologists, pharmacologists and statisticians. Patients on other investigational therapeutics are being systematically evaluated dermatologically at baseline and while on treatment. In addition to thorough clinical evaluations, subjects may undergo skin biopsies and medical photography.